DOI: 10.36347/sjams.2016.v04i02.050

Pages: 569-574

This study was done to evaluate the possible role of Anti-Citrullinated Peptide Antibody (ACPA) in determining disease activity and severity in patients of rheumatoid arthritis (RA) of less than one year duration. This hospital based observation study was done among 150 newly diagnosed RA cases of less than one year duration, diagnosed as per 2010 ACR/EULAR Classification Criteria for RA. Patients who were on DMARD or refused to give consent were excluded from the study. Disease activity was measured according to disease activity score (DAS-28). Blood sample was taken from each study participant and sent for complete blood count, erythrocyte sedimentation rate, rheumatoid factor, C-reactive protein and ACPA. ACPA positivity was found in 100/150(75%) cases of RA. RF titer was higher in ACPA positive (33.59 + 15.88 IU/ml) compared to ACPA negative cases (15.24 + 10.68 IU/ml) (p < .001). Among ACPA positive patients 82 (82.00%) had high DAS-28 score (>5.1) and 18 (18.00%) had moderate DAS-28 (5.1- 3.2). ACPA positivity was associated with high disease activity (p<0.01). RF positivity was higher in ACPA positive patients compared to ACPA negative patients (85% v/s 42%) (p < 0.001). All individual DAS-28 parameters were significantly higher in ACPA positive patients (p< .001). ACPA titer had statistically significant positive correlation with DAS-28 (r + 0.372, p<0.05), duration of disease (r +0.176, p< 0.05) and RF titer (r +0.451, p<0.01). We concluded that in RA, ACPA positivity was associated with higher disease activity (DAS-28). ACPA titer had positive correlation with disease activity (DAS-28). Thus ACPA positivity may be an indicator of active RA. ACPA positivity had no significant effect on severity (erosions) in RA of less than one year duration.